AEGiS-15IAC: HIV incidence among women of reproductive age in Malawi and Zimbabwe (HIVNET/HPTN 016A).

15th International AIDS Conference

Bangkok, Thailand - July 11-16, 2004

HIV incidence among women of reproductive age in Malawi and Zimbabwe (HIVNET/HPTN 016A).

Int Conf AIDS 2004 Jul 11-16; 15:(abstract no. ThOrC1426)

Kumwenda NI, Kelly C, Hoffman I, Chirenje M, Coletti A, Ristow A, Martinson F, Brown J, Richardson B, Chilongozi D, Padian N, Taha T
Johns Hopkins University, Baltimore, MD, United States

BACKGROUND: Clinical trials to evaluate the effectiveness of measures to reduce heterosexual HIV transmission (microbicides, treatment of STIs, promotion of behavior change, and vaccines) are being planned. Design and monitoring of these trials will require knowledge of baseline HIV incidence. We conducted a multisite prospective study in Blantyre and Lilongwe, Malawi, and Harare, Zimbabwe, to provide HIV counseling, promote condom use, and determine incidence of HIV and other STIs.

METHODS: Women of reproductive age were enrolled in a prospective study in which they received 3 intensive HIV counseling and condom promotion sessions over 2 months. Subsequently, HIV negative women completed quarterly follow-up visits in which counseling and male condoms were provided; structured interviews were conducted on sexual behavior, condom use and clinical history; pelvic examination was conducted; and HIV/STIs tests were performed.

RESULTS: A total of 2035 HIV negative women were enrolled in the condom promotion and counseling phase of the study. Of these, 1828 (559 in Blantyre, 614 in Harare and 655 in Lilongwe) were tested for HIV during follow-up for a total of 2463.3 woman-years (w-y). The median duration of follow-up was 1.4 years (interquartile range 1.2-1.7). A total of 115 women seroconverted, resulting in overall HIV incidence rate of 4.7 per 100 w-y (95% CI 3.9-5.6). Incidence rates (per 100 w-y) were similar across sites: 4.9 (95% CI 3.4-6.8), Blantyre; 4.9 (3.5-6.7), Harare; and 4.3 (3.1-5.9), Lilongwe. Consistent condom use increased from 51% at baseline to 65% at the last visit. Incidence rates (per 100 w-y) were<2.4 for each of gonorrhea, chlamydia and syphilis infections, 13.0 for trichomoniasis, and 25.0 for bacterial vaginosis. Conclusion The incidence of HIV and several STIs was high in these populations despite regular counseling, and condom promotion. Additional preventive measures such as vaginal microbicides are urgently needed.

Keywords: AEGIS, HIV Seropositivity, Incidence, Acquired Immunodeficiency Syndrome, Condoms, Malawi, Zimbabwe, Sexual Behavior, Counseling, Heterosexuality, Prospective Studies, Humans, Female, Male, epidemiology

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ThOrC1426